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FOOD FOR THE BRAIN

Food for the Brain and the Brain Bio Centre clinic

At Food for the Brain we wish to raise awareness of the importance of optimum nutrition in mental health. We are a charitable foundation working to inform organisations and empower individuals to change their diet and lifestyle and take greater control of their own mental health. Find out more about the charity and the work we do.

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ADHD; Dietary And Lifestyle Approaches To Help Manage Symptoms

What is ADHD?

Attention Deficit and Hyperactivity Disorder (ADHD) is a condition that relates to a collection of behavioural symptoms such as hyperactivity, impulsiveness and inattentiveness. It is most commonly diagnosed in childhood between the ages of 6 and 12 when disruptive behaviour begins to show, however, due to a growing awareness of the condition, it is also becoming common among adults. According to the thinktank Demos, the cost of undiagnosed ADHD in adults in the UK who are unable to work or hold down a full-time job are estimated to cost billions of pounds to the nation. They warn that too many may be going through life struggling, unable to access the support ot diagnosis they need, which means there could be a huge amount of wasted talent.

The most common front-line of treatment for ADHD is medication and cognitive behavioural therapy (CBT). Prescriptions for ADHD drugs such as Ritalin, have doubled to 922,000 a year in the last decade, and whilst it offers symptom management for many, it has also been found to have significant negative side effects such as weight loss, liver toxicity, and suicidal thoughts, and in the short term may suppress pubertal growth. The aetiology of ADHD is multifactorial, meaning that there are varying influencing factors that drive the symptoms. This is perhaps why this condition has been hard to study and find effective treatment for.

The Gut-Brain Link in ADHD

A key area that has been widely researched is the link between the microbiome (bacteria) in the gut and the brain. The hypothesis is that alterations in bacteria due to changes in our environment such as increased hygiene, increased exposure to antibiotics, refined and processed foods and stress have led to disturbances in short-chain fatty acids (SFCAs), which are byproducts of fermentation in the gut when bacteria come into contact with indigestible fibre found in food.

One SCFA in particular, called propionic acid, has been identified as a driver for abnormal behaviour that is related to both ADHD and the autism spectrum. This SCFA can alter metabolic and immune pathways, as well as gene expression, which can affect the functionality of the brain cells and their receptivity to neurotransmitters, as well as their ability to regenerate and regulate inflammatory responses. Certain strains of pathogenic bacteria, such as clostridia, have been implicated in producing large amounts of propionic acid. This strain of bacteria is naturally present in the gut, however, an overgrowth can occur when good bacteria levels are compromised and/or there is an acute infection. In addition, processed wheat and dairy products often contain propionic acid as a food preservative in the form of calcium propionate.

How to Support the Gut-Brain Connection

On the other hand, other SCFAs such as butyrate are well known for having health-promoting properties, such as producing anti-inflammatory effects by being able to regulate T-cells (immune cells) in the colon, as well as helping to maintain a healthy gut barrier function. In order to increase the favourable, health-promoting SCFAs, such as butyrate, it’s important to increase the intake of vegetables, fruits and good fats such as grass-fed butter, coconut oil, nuts and seeds, olive oil and avocado. These provide the bacteria with prebiotics, which is in other words, food for gut bacteria to feed on. Foods such as those listed above contain the right nourishment for gut bacteria to produce SCFAs that support health. Eating traditional foods such as fermented cabbage and other vegetables, as well as bone broth, are also rich in prebiotics and nutrients that support a healthy microbiome and digestive system.

How Toxins and Heavy Metals Affect the Brain

Exposure to toxins and heavy metals has also been implicated in the aetiology of ADHD.Research shows that significant childhood exposure to heavy metals and chemical compounds, promote neurodevelopmental toxicity and may be one of the underlying drivers of behavioural disorders among children.

Pthalates - How to Avoid them

For example, prenatal exposure to pthalates, which are chemical compounds that are commonly added to plastics to increase their durability and flexibility, have been linked tobehavioural abnormalities characterised by shortened attention span and impaired social interaction. Pthalates are an extensive group of chemicals, and whilst not all of them have been studied, several have shown to have negative health impacts. This class of chemicals is found abundantly and can find they can find their way into food packaging, cosmetics and household cleaners - making them virtually impossible to avoid. However, a growing awareness about the potential negative impact on health has led to the production of pthalate-free cosmetic and personal care products, as well as cleaning products. It may, therefore, be a significant step to try to avoid these chemicals by choosing products wisely, as well as trying to buy vegetables, fruit etc that haven’t been wrapped in plastic.

The Blood Brain Barrier and Heavy Metals

Mercury exposure is among several other heavy metals, such as lead, aluminium and cadmium, that have been implicated in the aetiology of ADHD. Childhood exposure to mercury is predominantly through the consumption of seafood, dental amalgams and vaccines containing thimerosal. The reason why mercury can be so problematic, as well as other metals, is that it is capable of breaching the blood brain barrier. This is the brain’s ‘high fortress’, an intelligent gateway system that filters through molecules that are needed in the brain such as cells, nutrients and signalling molecules, and filters out pathogens and toxins.

Mercury, as well as other heavy metals such as lead, can accumulate in brain tissue, as well as in the spinal cord, as they are fat-soluble - meaning that they can hide itself in fat tissue, which is abundant in both the brain and the spine. Once there, they can displace important nutrients for brain health such as zinc and iron, which are needed for neurotransmitter production, as well as induce an inflammatory process called oxidative stress among other things.

Dietary Steps to Avoid Heavy Metal Toxicity

Choose the right fish

An important dietary step to avoid heavy metal toxicity is choosing seafood and fish that has reduced levels of exposure. The Seafood Watch web page is a fantastic resource that has an extensive list of fish, seafood and sushi products that are safe, as well as those that are best to stay away from. For example, choosing wild pacific caught salmon is safer than Atlantic caught salmon.

Enhance Glutathione Levels

The body has its own inherent detoxification pathways that are responsible for packaging and removing heavy metals safely from the system. For example, glutathione is known as the body’s ‘master antioxidant’ and aside from playing an important role in preventing free radicals from causing damage to the body’s cells, it also helps to bind to heavy metals and remove them from the body. Research shows that glutathione levels are lower than normal in those on the autism spectrum, so enhancing levels through the diet may be an effective way to prevent the accumulation of heavy metals. Consuming sulfur-rich foods such as broccoli, cabbage, onions, garlic, kale and cauliflower can boost glutathione levels, as well as milk thistle, which has unique flavonoids that also support glutathione production.

Invest in a water filter

Most water filters on the market only filter out bacteria, parasites and organic compounds. There is a different method to filter out heavy metals, so make sure it explicitly says it does. The reverse osmosis method seems to be the most effective and can be integrated into the kitchen tap.

Increase intake of butyrate (SCFA) producing foods

As mentioned above, eating foods that are rich in indigestible fibre such as vegetables and fruits, as well as eating good fats that are found in grass-fed butter, nuts and seeds, olive oil, coconut oil and avocado, provide bacteria with prebiotics that help to produce the ‘friendly’ short-chain fatty acids such as butyrate. Avoiding processed foods that contain calcium propionate, which lead to higher levels of propionic acid - the not so friendly short-chain fatty acid - is also another key strategy to support the gut-brain link.

Other Strategies to Keep in Mind...

There are many more steps to help support the optimal functioning of the brain and therefore encourage improved learning and development. However, another key strategy to support brain health is to increase intake of omega 3, an essential fatty acid, that is most abundantly found in oily fish such as salmon, mackerel and sardines. Be sure to choose salmon that has had less exposure to polluted water - visit the Seafood Watch web page to find the best sources. Omega 3 is vital for the brain’s function, particularly one of its components called DHA. This is a key building block for the brain and is what keeps neurons (brain cells) working well and supports proper signalling via neurotransmitters.

Lastly, this may seem like a no-brainer, however, avoiding refined sugar and processed foods at all costs is essential for managing ADHD symptoms. These foods have a negative impact on blood sugar levels, which consequently affect mood and concentration.

If you’d like more information and support on how to improve your child’s diet, please head to our ‘Smart Kids’ resources on our website where you’ll find free recipes, supplement guidelines and a questionnaire which tests your child’s diet and performance, as well as giving personalised advice on simple changes that will maximise their potential.

Food Intolerance, the Gut - Brain Axis and Mental Health

We recently held an informative event in London with Dr Gill Hart, a biochemist and expert in the field of food intolerances and their global effect on health and we wanted to share some of the highlights of what Dr Hart covered. Based on some of her recent research (1), the talk offered some interesting insights into how food intolerances may have a role to play in our mental health. It honed in on the differences between food allergies and food intolerances within our immune system; some of the ways that our immune system, gut and brain are believed to influence each other, and how food intolerances, therefore, can play a role in mental health symptoms. She also spoke about how to go about testing and managing these intolerances through elimination diet strategies.

The ‘Brain-Gut Axis’ is a term used to describe the two-way communication system between our digestive tract and the brain. A growing body of research into this axis demonstrates how much influence the gut can have over the brain and vice versa (1). When we speak about reactions to foods, we most commonly understand them as immediate and often dangerous allergic responses, such as the constriction of the throat and trouble breathing, or dizziness and fainting. It is usually easy to pinpoint the food that causes these reactions because of the immediate immune system response, caused by a type of immune cell known as IgE antibodies. In contrast to this, food intolerances are mediated by IgG antibodies and these reactions can take up to 48 hours to have an effect. Symptoms related to IgG reactions can often be manifested as chronic issues like joint ache, IBS and depression or anxiety, which are often overlooked and not associated with what we eat.

Dr Hart explained how communication between the gut and the brain is controlled via our immune system, our endocrine system (hormones) and our central nervous system, which are all under the influence of the bacteria in our gut. The types and amount of these bacteria, known as our gut microbiome, can be directly impacted by factors such as diet, stress, pollution and medications (2) and the composition of the microbiome is also understood to affect one’s susceptibility to food sensitivities and intolerances (3).

To understand further about how food intolerances can impact our mental health, it is important to explain the relationship between our gut microbiome, the immune system and our brain in a little more detail. The walls of our digestive tract provide a barrier between what we eat and the rest of our body and an unhealthy gut microbiome can lead to increased levels of inflammation, leaving the walls vulnerable to structural damage (4). Our intestinal wall is composed of cell junctions that prevent bacteria and large food molecules from entering the bloodstream, however, if these become damaged, proteins from foods that should not be circulating in our bloodstream can enter and an immune response is mounted as a reaction. This response is mediated by IgG, an antibody, that helps to protect against bacterial and viral infections as well as food antigens and is the most abundant immune cell in the body. Whilst food antigens are usually quickly cleared by an intelligent system called the reticuloendothelial system, with structural damage and a poor gut microbiome, this immune response can keep reoccurring. It is suggested that a chronic immune response such as this can have a negative impact on the brain, damaging its own structural barrier, called the Blood Brain Barrier (5).

The Blood Brain Barrier (BBB) is similar in structure to the intestinal barrier (6) and is usually highly selective, allowing certain required metabolic products such as short chain fatty acids and amino acids to pass into the brain from our wider circulation but protecting the brain from potentially damaging components. When the BBB is compromised, unwanted translocation may occur such as allowing a bacterial invasion, which can alter the function of immune cells that are responsible for regulating inflammation. Chronic inflammation is associated with many mental and physical health problems, so it is therefore suggested that poor gut health can have a direct correlation to poor mental wellbeing, as a result of a compromised intestinal barrier and the negative impact this has on our brain’s own structural barrier (BBB) and resulting inflammation.

Large scale studies have shown the association between chronic low-grade inflammation and depression (8). For example, in a study that examined data from 14,275 people who were interviewed between 2007 and 2012, they found that people who had depression had 46% higher levels of C-reactive protein (CRP), a marker of inflammatory disease, in their blood samples (9). Studies like these are paving the way towards a new understanding of the pathology of mental health conditions and how diet and stress can alter bodily systems, such as digestive function and consequently impact mental wellbeing. Measuring IgG antibodies in food intolerance tests has been implicated as a popular strategy to tackle symptoms related to sensitivities such as IBS, joint pain, fatigue, migraines, anxiety and depression. A recent survey on 708 people commissioned by Allergy UK, demonstrated how 81% of those with elevated IgG levels, as well as psychological symptoms, reported an improvement in their condition after following a food-specific IgG elimination diet (9). Taking this all into account, health professionals and those with poor mental health may want to consider the potential role of food intolerances in mental well-being and in managing common mood-related disorders, such as depression and anxiety.

Dr Hart talked through food intolerance tests that are available through a number of well known companies, including York Test for whom she is Scientific Director. A possible strategy could be to use such testing to identify intolerances, follow an elimination protocol, temporarily removing on foods triggering an IgG response; and then work to improve your gut health to support longer term well-being. Foods that are rich in collagen and its amino acids, like glycine and proline, are great for healing connective tissue, which is what the intestines are made up of. A traditional food, rich in these amino acids, that has made its way into our kitchens again after rediscovering its therapeutic properties is bone broth. Another example of a group of traditional foods that can be used therapeutically in building digestive health, are fermented foods such as kefir, sauerkraut and kimchi. These are abundant in probiotics, which are the ‘good’ bacteria our digestive system needs to help keep a good balance and protect the intestinal barrier from pathogens, toxins and parasites. Once these foods have been introduced on an everyday basis along with eating a healthy nutrient-dense diet and the possible use of supplements to help restore balance, you may be able to reintroduce foods that were previously triggering an IgG response carefully, one at a time, whilst monitoring symptoms.

It is important that this type of approach is discussed with a qualified health professional, such as a registered nutritional therapist, to ensure it is an appropriate strategy for you, as well as to help you avoid missing out on vital nutrients, whilst eliminating certain foods. They can also provide advice on improving your longer term health, which over time may allow for foods to be reintroduced without negative symptoms occurring.

Nutritional support for depression before, during and after pregnancy

According to Dr Vivette Glover, Director of the Foetal and Neonatal Stress and Research Centre, at any one time during pregnancy, one in every ten women will be depressed and around one in every thirty will be depressed both during pregnancy and the postnatal period (1). It is not yet understood exactly what causes the symptoms associated to depression during and after pregnancy. However, factors such as the large changes that the body undergoes due to the demands of the growing foetus, as well as breastfeeding and potential sleep deprivation, can all play a significant role in how the body deals with stress. It is during this period of time that our bodies require more nourishment from food than ever and it can also be at exactly this time when we perhaps struggle to prioritise nutrition due to lack of energy, loss of appetite or sickness.

Pre and Post-Natal Depression are both complex conditions that can have multifactorial underlying drivers, including genetic and environmental influences. These are currently poorly investigated and the gold standard of treatment is often medication to help stabilise mood. Whilst SSRIs and other types of antidepressants have proven to be helpful for many, they do not address potential causes or drivers of poor mental health and can often mask symptoms. Antidepressants are also not regularly recommended during pregnancy, which is why being more mindful of nutrition and lifestyle habits can be a safer option for you and your baby. There are some natural, evidence-based steps you can take to help support optimal mental wellbeing:

Eat Foods to Support Energy Depletion:

Common issues such as poor sleep during pregnancy and sleep deprivation following the birth can often heighten cravings for stimulants and sugary foods, which may seem like a good option for quick sources of energy, however, these foods can often cause further issues with energy and lead to fatigue and low mood. Eating foods that are high in refined sugar and refined grains such as commercial white bread, pastries, cakes and biscuits, give us an unsustainable source of energy. The brain is a very metabolically active organ; despite it only being 7% of the body’s weight, it can take up to 20% of the body’s metabolic needs (2), meaning that it is very energy hungry. This is why it is important to nourish the brain with foods that are nutrient rich, providing the body the building blocks to produce neurotransmitters, as well as a sustainable source of energy. The best options are fresh, unprocessed foods such as wholegrains (brown bread, brown rice, quinoa, rye and oats), pulses, vegetables, good quality sources of protein (meat, poultry and fish) and healthy fats such as those found in olive oil, coconut oil, avocados and oily fish.

Just like throughout pregnancy, nutritional needs after birth, especially if breastfeeding, are incredibly important. The healthier the diet, the easier it will be to sustain the energy needed to take care of a newborn. Research shows that a breastfeeding mother needs an extra 300-500 calories a day, from food that is rich in the right macro and micronutrients to nourish both mother and baby (3). For example, nutrients such as B vitamins have shown to be important in supporting the mother in ensuring she has enough energy to meet the demands of lactation (4). These nutrients can be found in green leafy vegetables, wholegrains and good sources of animal protein.

Protect yourself from Oxidative Stress:

Oxidative stress refers to a biochemical process that occurs as a result of an accumulative everyday exposure to toxic burdens such as chemicals in cosmetics, furniture, paints, cars, and pollution. Our body has its own way of armouring itself from the damage that exposure to toxins can create through its production of endogenous antioxidants, which is nature’s way of neutralising oxidative stress. Although we have our own production of these wonder molecules, when we are continuously overloaded with toxins in our environment and have problems detoxifying, the liver can become overwhelmed. Research shows that over time oxidative stress can lead to an increase in inflammatory molecules such as cytokines, which have been shown to correlate with depression (5).This is why it is important to have a high intake of nutrients that support the liver in metabolising and removing toxins from the body, as well as regulating the inflammatory response. There are a few things we can change in our diet to support this area, for example eating foods such as the cruciferous family of vegetables which includes kale, cauliflower, broccoli and cabbage. These are particularly effective at supporting the liver in ushering out toxins as they all share an antioxidant compound called indole-3 Carbinol, which plays an important role in liver health (6). In addition, bitter greens such as collard greens, rocket, chicory and swiss chard are also great for supporting the liver’s own antioxidant defence system.

Increase intake of Omega-3 Fatty Acids:

During pregnancy and after pregnancy there is often a concern for the potential depletion of the maternal nutrient reservoir due to the needs of the growing foetus. A nutrient that is particularly important for mental wellbeing and is also essential for the growth of the foetus’s brain, is DHA. This is an omega 3 fatty acid that is found in oily fish and is the primary structural component of brain tissue, as well as playing a crucial role in the maintenance of brain cells and neurotransmitter metabolism (our body can also convert plant sources of omegas 3’s into DHA, such as those found in flaxseeds or chia seeds into DHA, but the conversion can often very poor). Deficiency in this nutrient during pregnancy is common, namely because of lack of seafood intake (the most bioavailable source of DHA) due to poor eating habits and concerns of mercury levels in fish during pregnancy, as well as higher requirements during foetal growth, which can lead to depletion. Due to the role that DHA plays in neurotransmitter metabolism, deficiency in this nutrient has been correlated to symptoms of depression during pregnancy (7). In order, to support your intake of omega 3, aim to have 3 portions of oily fish a week from sources that are low in mercury. These are mainly small fish that have a short life-span such as sardines, mackerel and herring. If you are vegetarian or vegan, although omega 3 is less readily available, it is still possible to get this nutrient from your diet through flax seeds, chia seeds, walnuts and seaweed. If you feel you may not be getting enough through your diet, you may want to consider using a good quality fish oil supplement (or algae based supplement if vegan) as an option. With fish oils, aim to choose a supplement that has been filtered for heavy metals and other pollutants to make sure you're getting the full benefits of the omega 3 oils.

Exercise and Personalised Nutritional Therapy:

In addition to diet, there are many other things you can also do related to lifestyle, such as stress management through mindfulness (8) or gentle movement such as pre or post natal yoga (9), which have both shown to be incredibly helpful in encouraging mental wellbeing. If you feel you need extra support, personalised nutritional therapy can be very helpful as there can often be other drivers such as nutrient deficiencies and digestive complaints that can play a significant role in mental health and will need to be addressed in a way that is tailored to the individual.

At the Brain Bio Centre, our nutritional therapy clinic, our therapists specialise in mental health and biochemical testing that can provide in-depth information about your own specific needs, so we can create a personalised plan to support your health. For more information, please visit our website: www.brainbiocentre.com. Alternatively, BANT (British Association for Applied Nutrition and Nutritional Therapy), have a large network of therapists you can use to find a therapist suitable for you.For wider help and information, you might want to contact the PANDAS Foundation, a charity who offer pre and post natal advice and support. They also have a helpline, 0843 28 98 401, open 9am-8pm, 7 days a week.

What's So Blue about Blue Monday?

It’s that time of the year again. It’s Blue Monday. We’re halfway into January, trudging through the deepest and darkest of the winter months, as we try to keep our heads high after the Christmas festivities with the motivation of our New Year’s resolutions. Some of you may have never heard of Blue Monday and let’s just say you’re not exactly missing out.

So where did the idea of Blue Monday come from? The concept of Blue Monday was originally coined by Dr Cliff Arnall in 2005 and distributed by the PR company Sky Travel. It has now become an annual event and can fall on either the third or the fourth Monday of January, using Dr Cliff Arnall’s original mathematical equation that measures a combination of factors such as weather, potential debt post-Christmas, the amount of time since Christmas, potential failure of New Year resolutions and motivation levels, that apparently conspire to make the date the gloomiest of the year.

Over the years, science has looked into the validity of this date being the most blue of all dates, however there is little evidence to prove this. There is some research that suggests how weekends are a time when people generally feel happier and less anxious, mostly for those that work full-time Monday-Friday, however there is little difference with subjective mood for other days of the week. Some charities such as MIND, have even said that Blue Monday, which is used mainly as a marketing tool to sell products and stories, can also be dangerously misleading and have even set up the hashtag #BlueAnyDay to help dispel the myth of this date.The idea that as a population we are more likely to feel down on the third of fourth Monday of the year can not only trivialise depression as a medical illness that can be life threatening but can also affect those that live with depression and know too well that feelings associated to this illness are not dictated by a single date in the diary.

Of course, work pressure, post-Christmas financial constraints and time away from family and friends can make us all feel low, however, this can happen on any date depending on our own personal circumstances. Rather than taking a ‘duvet day’ to bail out of commitments on Blue Monday, as the media is suggesting, why not take a more positive stance and engage in some activities that are tried and tested tools to help support better mood? After all, as the evidence suggests, the date or day of the week is unlikely to change these worries for the majority of us. For example, doing some exercise and eating a healthy meal with good company are both scientifically proven to support our mental wellbeing. Low-intensity exercise such as walking sustained over an extended period can help release proteins called neurotrophic factors that improve brain function and support mood, and nutrients such as B12 and Omega 3, are just two of many that have been shown to improve symptoms associated to depression. Our Nutrition Solutions offers more information on nutrition for depression if you want to know more about practical actions you can take yourself through nutrition to prevent or tackle depression.

If you are in or are able to come to London, you may be interested in also coming to a one day workshop we are hosting with Patrick Holford, our founder and one the UK’s leading nutritional therapists. We are excited to be running this workshop, which enables our supporters to access Patrick’s wealth of knowledge on nutrition and mental health. More details can be found below. If you are outside of the UK and are interested in this workshop or learning more about nutrition and mental health, please sign up for news on our Seminar series here.

For more in-depth personalised support, some people find nutritional therapy hugely beneficial. To find a suitable therapist, please head to BANT (British Association of Applied Nutrition and Nutritional Therapy) or contact our not-for-profit clinic, the Brain Bio Centre (www.brainbiocentre.com), which offers expertise in nutritional therapy for mental health conditions including depression, on 0208 332 9600 or info@brainbiocentre.com. If you feel you need more immediate help, for whatever it is that you’re going through, theSamaritans helpline offer support 24 hours a day, 365 days a year and can point you in the right direction of getting further help.